Medical and Dental Consultantsí Association of Nigeria
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   2018| March  | Volume 21 | Issue 3  
    Online since March 9, 2018

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Patient Self-reported quality of life assessment in Type 2 diabetes mellitus: A pilot study
HR PrasannaKumar, MG Mahesh, VB Menon, KM Srinath, KC Shashidhara, P Ashok
March 2018, 21(3):343-349
DOI:10.4103/njcp.njcp_433_16  PMID:29519984
Background: Quality of life (QoL) is an important outcome measure to assess the diabetic care and is increasingly replacing the traditional indicators of health. Aim: The aim is to evaluate the QoL in patients with type 2 diabetes mellitus (DM) using a third generation individualized QoL instrument like an audit of diabetes-dependent QoL (ADDQoL) questionnaire and to determine the predictors. Materials and Methods: Patients who met the inclusion and exclusion criteria were recruited from a tertiary care hospital by convenience sampling. Sociodemographic and other relevant details were collected from the study patients, and ADDQoL questionnaire were administered to them. Results: A total of 200 patients were included in the study among which 66% of patients had uncontrolled type 2 DM as suggested by their glycated hemoglobin (HbA1c) values. The mean QoL score was 0.07 (0.91) and diabetes-dependent QoL was −1.33 (0.58). Approximately 38% were associated with poor health-related QoL with a mean average weighted impact score of −0.51 (0.51). Most frequently affected life domain was the freedom to eat. A positive correlation was observed between QoL and gender, age, domicile, education status, occupation, family structure, duration of type 2 DM, HbA1c, insulin treatment, and the presence of comorbidities. Conclusion: The study highlights the impact of type 2 DM on QoL. Improving QoL of type 2 diabetic patients is important and knowledge of these preventable risk factors help to implement strategies to better management of type 2 DM and ultimately improve therapeutic outcome.
  1,683 371 -
Accuracy of the demirjian, willems and cameriere methods of estimating dental age on turkish children
BK Apaydin, F Yasar
March 2018, 21(3):257-263
DOI:10.4103/1119-3077.226966  PMID:29519970
Background and Aim: Age estimation plays a significant role in forensic science, archeology, pediatric endocrinology and clinical dentistry. Tooth development is a reliable pathway for age estimation, especially in children. The aim of this study was to evaluate the accuracy of the Demirjian method (DM), Willems method (WM) and Cameriere method (CM). Materials and Methods: This study included panaramic radiographs of 330 individuals (165 girls, 165 boys) aged between 5 and 15.90 years. The differences between chronological age (CA) and the estimated dental age (DA) were statistically tested using a paired sample t-test and the Wilcoxon signed rank test. Results: The mean prediction error showed that; the DM overestimated the DA by 0.304 years, the WM underestimated the DA by -0.060 years and the CM underestimated the DA by -0.580 years. The difference between CA and estimated DA was not statistically significant according to WM (p = 0.074) and statistically significant according to DM and CM (p < 0.001). Conclusion: In conclusion, this study indicated that WM determines DA satisfactorily in a Turkish subpopulation.
  1,581 445 -
The evaluation of stress patterns in porcelain laminate veneers with different restoration designs and loading angles induced by functional loads: A three-dimensional finite element analysis study
O Ustun, AN Ozturk
March 2018, 21(3):337-342
DOI:10.4103/njcp.njcp_45_17  PMID:29519983
Background: Fractures in porcelain laminate veneers (PLVs) are a significant clinical problem. Preparation designs can affect stress distribution, which leads to fractures in PLVs. Therefore, identification of the most favorable preparation design in terms of stress distribution is required. Objective: The purpose of this study is to examine the functional stress patterns of PLVs with featheredge, incisal bevel, and overlapped preparation designs under 0°, 60°, and 120° functional loads using finite element analysis. Materials and Methods: Porcelain veneers with three different preparation designs (incisal overlap, incisal bevel, and featheredge) were modeled. A cement layer of 100 μm of luting composite resin was assumed, and a thickness of 0.5 mm of porcelain veneers was used. All models were loaded at 0°, 60°, and 120° to the long axis of the tooth to determine the stresses that may occur during mastication under different load angulations. A total force of 200 N was applied from the incisal edge of the models. Results: Maximum stresses were recorded in the incisal overlapped design (53.3 MPa) under 120° of functional load. Minimum stresses were recorded in the incisal bevel preparation design (22.37 MPa) under 0° of functional load. Conclusion: Both the preparation design and load angle affected the stress distribution on the PLVs. The incisal bevel preparation design provided a more appropriate geometry for stress distribution compared with the other techniques. Lateral forces produced more stress on the tooth and laminate material than vertical forces.
  1,492 370 -
In vitro Fracture strength and hardness of different computer-aided design/computer-aided manufacturing inlays
O Sagsoz, M Yildiz, A S L Hojjat Ghahramanzadeh, A Alsaran
March 2018, 21(3):380-387
DOI:10.4103/njcp.njcp_58_17  PMID:29519990
Objective: The purpose of this study was to examine the fracture strength and surface microhardness of computer-aided design/computer-aided manufacturing (CAD/CAM) materials in vitro. Materials and Methods: Mesial-occlusal-distal inlays were made from five different CAD/CAM materials (feldspathic ceramic, CEREC blocs; leucite-reinforced ceramic, IPS Empress CAD; resin nano ceramic, 3M ESPE Lava Ultimate; hybrid ceramic, VITA Enamic; and lithium disilicate ceramic, IPS e.max CAD) using CEREC 4 CAD/CAM system. Samples were adhesively cemented to metal analogs with a resin cement (3M ESPE, U200). The fracture tests were carried out with a universal testing machine. Furthermore, five samples were prepared from each CAD/CAM material for micro-Vickers hardness test. Data were analyzed with statistics software SPSS 20 (IBM Corp., New York, USA). Results: Fracture strength of lithium disilicate inlays (3949 N) was found to be higher than other ceramic inlays (P < 0.05). There was no difference between other inlays statistically (P > 0.05). The highest micro-Vickers hardness was measured in lithium disilicate samples, and the lowest was in resin nano ceramic samples. Conclusion: Fracture strength results demonstrate that inlays can withstand the forces in the mouth. Statistical results showed that fracture strength and micro-Vickers hardness of feldspathic ceramic, leucite-reinforced ceramic, and lithium disilicate ceramic materials had a positive correlation.
  1,401 351 -
Effect of adhesive resin cements on bond strength of ceramic core materials to dentin
M Gundogdu, LI Aladag
March 2018, 21(3):367-374
DOI:10.4103/njcp.njcp_10_17  PMID:29519988
Objectives: The aim of the present study was to evaluate the effects of self-etch and self-adhesive resin cements on the shear bond strength of ceramic core materials bonded to dentin. Materials and Methods: Extracted, caries-free, human central maxillary incisor teeth were selected, and the vestibule surfaces were cut flat to obtain dentin surfaces. Ceramic core materials (IPS e.max Press and Prettau Zirconia) were luted to the dentin surfaces using three self-etch adhesive systems (Duo-Link, Panavia F 2.0, and RelyX Ultimate Clicker) and two self-adhesive resin systems (RelyX U200 Automix and Maxcem Elite). A shear bond strength test was performed using a universal testing machine. Failure modes were observed under a stereomicroscope, and bonding interfaces between the adhesive resin cements and the teeth were evaluated with a scanning electron microscope. Data were analyzed with Student's t-test and one-way analysis of variance followed by Tukey's test (α = 0.05). Results: The type of adhesive resin cement significantly affected the shear bond strengths of ceramic core materials bonded to dentin (P < 0.05). Significant differences were noted between the ceramic core materials when the specimens were luted with self-adhesive resin cements (P < 0.05). The specimens luted with RelyX Ultimate Clicker had the highest shear bond strengths. Conclusion: The self-etch adhesive resin cements exhibited better shear bond strength than the self-adhesive resin cements, except for Panavia cement in the IPS e.max Press group. However, shear bond strengths of the self-adhesive resin cements were dependent on the nature of the ceramic core materials.
  1,387 326 -
E-learning readiness from perspectives of medical students: A survey in Nigeria
IE Obi, AN Charles-Okoli, CC Agunwa, BI Omotowo, AC Ndu, OR Agwu-Umahi
March 2018, 21(3):293-300
DOI:10.4103/njcp.njcp_108_17  PMID:29519976
Context: Learning in the medical school of the study university is still by the traditional face-to-face approach with minimal e-communication. Aim: This paper assesses student's perspectives of E-learning readiness, its predictors and presents a model for assessing them. Settings and Design: A descriptive cross-sectional study of medical students. Subjects and Methods: By proportional quota sampling 284 students responded to a semi-structured self-administered questionnaire adapted from literature. Ethical issues were given full consideration. Statistical Analysis Used: Analysis was with SPSS version 20, using descriptive statistics, ANOVA, Spearman's correlation, and multiple regression. Statistical significance was considered at P < 0.05. Results: Medical students are ready for E-learning (Mlr = 3.8 > Melr = 3.4), beyond reliance on the face-to-face approach (69.7%), expecting effective (51.1%), and quality improvement in their learning (73.1%). Having basic information and communications technology skills (68.9%) (Mict = 3.7 > Melr = 3.4), access to laptops (76.1%), ability to use web browsers confidently (91.8%) (Mwb = 4.3 > Melr = 3.4), with only few able to use asynchronous tools (45.5%), they consider content design important to attract users (75.6%), and agree they need training on E-learning content (71.4%). They however do not believe the university has enough information technology infrastructure (62.4%) (Mi = 2.7 < Melr = 3.4) nor sufficient professionals to train them (M = 2.9). Predictors are attitude, content readiness, technological readiness, and culture readiness. The model however only explains 37.1% of readiness in the population. Conclusions: Medical students in this environment are ready to advance to E-learning. Predicted by their attitude, content, technological and cultural readiness. Further study with qualitative methodology will help in preparing for this evolution in learning.
  1,395 246 -
The In vitro Evaluation of the effect of xyliwhite, probiotic, and the conventional toothpastes on the enamel roughness and microhardness
E Arat Maden, C Altun, G Guven Polat, F Basak
March 2018, 21(3):306-311
DOI:10.4103/njcp.njcp_431_16  PMID:29519978
Aim: The aim of this study was to evaluate the effect of fluoride, Xylitol, Probiotic, and Whitening toothpastes on the permanent teeth enamel roughness and microhardness. Materials and Methods: One hundred and twenty teeth were randomly divided into 2 groups, each group having 60 samples. G1: The group in which enamel roughness was examined (n = 60). G2: The group in which enamel microhardness was examined (n = 60). Then, these groups were randomly divided into 4 groups among themselves (n = 15). Each group was brushed using four different toothpastes for 1 week with a battery-powered toothbrush in the morning and evening for 2 min. Vicker's hardness tester was used to measure the changes in microhardness, and the profilometer was used to measure the changes in surface roughness. Results: No statistically significant differences were found on surface roughness and microhardness values measured after tooth brushing process in group brushed with Colgate MaxFresh toothpaste (P > 0.01). Statistically significant decrease was observed on Vicker's hardness values measured after tooth brushing process in groups brushed with Ipana White Power Carbonate toothpaste, Xyliwhite Toothpaste Gel, and Periobiotic Probiotic Toothpaste (P < 0.01). Statistically significant increase was observed on surface roughness values in groups brushed with Ipana White Power Carbonate toothpaste, Xyliwhite Toothpaste Gel, Periobiotic Probiotic Toothpaste (P < 0.01). Conclusions: As a result, Colgate MaxFresh abrasive-free toothpaste with fluoride has no effect on permanent tooth enamel surface roughness and microhardness. Xyliwhite, Periobiotic, and Ipana White Power Carbonate-containing abrasive toothpastes led to changes negatively on permanent tooth enamel surface roughness and microhardness.
  1,279 273 -
Health of periodontal tissues and resorption status after orthodontic treatment of impacted maxillary canines
AZ Oz, S Ciger
March 2018, 21(3):301-305
DOI:10.4103/njcp.njcp_419_16  PMID:29519977
Objective: The aim of the present study was to evaluate the changes of incisor root resorption associated with impacted maxillary canines and health of periodontal tissues around maxillary canines erupted with orthodontic treatment. Materials and Methods: Twenty patients with a unilateral palatally impacted maxillary canine were included in the study. Cone-beam computed tomography images taken before and after orthodontic treatment were compared with the contralateral canines serving as control teeth. Results: Root resorption was present in 10% of central and 40% of lateral incisors before treatment. After treatment, the incidence of resorption decreased. The thickness of the buccal bone surrounding the impacted canines was similar to that surrounding the contralateral canines, except in the apical area. Periodontal pocket depth and alveolar bone loss were greater for the impacted canine teeth than for the contralateral canines. Conclusions: Incisor root resorption associated with impacted canine teeth showed signs of repair after orthodontic treatment. Slight differences related to periodontal health were found between the previously impacted teeth and contralateral canine teeth.
  1,178 350 -
Relationship between salivary calprotectin levels and recurrent aphthous stomatitis: A preliminary study
M Koray, B Atalay, S Akgul, FS Oguz, G Mumcu, A Saruhanoglu
March 2018, 21(3):271-275
DOI:10.4103/njcp.njcp_23_17  PMID:29519972
Aim: Recurrent aphthous stomatitis (RAS) is an inflammatory condition of the oral mucosa. The etiology of RAS remains unclear. Calprotectin is a major cytoplasmic protein contained in granulocytes, monocytes/macrophages and epithelial cells, and its level is increased body fluids in some inflammatory diseases. The aim is to determine the relationship between salivary calprotectin and RAS. Material and Methods: In the cross-sectional study, 67 patients with active lesions of RAS (F/M: 43/24, mean age: 30.27 ± 9.14 years) and 42 healthy controls (HC, F/M: 30/12, 30.54 ± 9.49 years) were included. Calprotectin levels were evaluated in unstimulated whole saliva samples by using the ELISA method in both groups. Results: Salivary calprotectin levels were significantly higher in RAS group (23.72 ± 4.28 mg/L) compared to the HC group (21.59 ± 4.27 mg/L) (P = 0.013). No significant relationship was found between calprotectin levels and age or gender in both groups (P >0.05). Conclusion: RAS is a very common inflammatory ulcerative condition of the oral cavity and its etiology is uncertain. Regarded as an inflammatory mechanism, releasing a high level of calprotectin in saliva has been suggested that it may play a role in pathogenesis of RAS.
  1,110 287 -
The efficiency of different irrigation solutions and techniques for the removal of triple antibiotic paste from simulated immature root canals
Y Ustun, S Düzgün, T Aslan, A Aktı
March 2018, 21(3):287-292
DOI:10.4103/njcp.njcp_29_17  PMID:29519975
Introduction: The purpose of this study was to evaluate the efficiencies of different irrigation protocols in the removal of triple antibiotic paste (TAP) from root canals. Materials and Methods: A total of 127 extracted human maxillary incisor teeth were prepared. Then, root-end resection of 3 mm was accomplished to simulate immature apex model. The root canals were filled with TAP, after 21 days, randomly divided into nine groups according to irrigation systems and solutions (n = 13). Conventional irrigation (CI) groups - Group 1: Root canal irrigation was performed with CI by Peracetic acid (PAA) solution, Group 2: Root canal irrigation was performed with CI by etidronic acid 1-hydroxyethylidene-1, 1-bisphosphonate (HEBP) + sodium hypochlorite (NaOCl) solution, Group 3: Root canal irrigation was performed with CI by ethylenediaminetetraacetic acid (EDTA)/NaOCl solutions. Vibringe system groups - Group 4: Root canal irrigation was performed with Vibringe system by PAA solution, Group 5: Root canal irrigation was performed with Vibringe system by HEBP + NaOCl solution, Group 6: Root canal irrigation was performed with Vibringe system by EDTA/NaOCl solution. EndoVac system groups - Group 7: Root canal irrigation was performed with EndoVac system by PAA solution, Group 8: Root canal irrigation was performed with EndoVac system by HEBP + NaOCl solution, Group 9: Root canal irrigation was performed with EndoVac system by EDTA/NaOCl solution. Control Group: (n = 0). Samples were sectioned vertically, and the amount of remaining medicament was scored for each root half and data were statistically analyzed. Results: Among the irrigation systems, CI groups showed the highest scores at both apical and coronal parts (P < 0.05). In comparisons among the solutions, at the apical part, PAA groups showed the highest scores (P < 0.05). At the coronal part, EDTA + NaOCl groups showed the lowest score values (P < 0.05). Conclusion: The use of irrigation systems improved the removal of TAP from the simulated immature root canals. Also, as an irrigation solution EDTA gives more promising results than PAA and HEBP solutions.
  1,137 254 -
Helicobacter pylori and precancerous lesions of the stomach in a Nigerian Metropolis: A Cohort Study
E Ray-Offor, CC Obiorah
March 2018, 21(3):375-379
DOI:10.4103/njcp.njcp_302_17  PMID:29519989
Introduction: Helicobacter pylori (H. pylori)-related atrophic gastritis transits through a sequential pathway of intestinal metaplasia, dysplasia to gastric cancer. Gastroscopy offers early detection, treatment and surveillance of gastric cancer.Aims: This study aims to study the prevalence of H. pylori infection and evaluate precancerous lesions (PCLs) of the stomach. Patients and Methods: This is a case controlled study of patients with dyspepsia undergoing gastroscopy at a referral endoscopy facility in Port Harcourt metropolis of Nigeria. The variables studied included demographics, clinical, endoscopic, and histopathologic findings. Statistical analysis of data was done using IBM SPSS Statistics for Windows, Version 20.0. (Armonk, NY, USA). Results: A total of 104 patients were included in the study. Age ranged from 20 to 80 years (mean 47.1 ± 14.4 years); 56 were males and 48 were females. H. pylori were detected in 40 (38.5%) mucosal biopsies. The prevalence of PCLs was: chronic atrophic gastritis 6.7% (7 cases); intestinal metaplasia 2.9% (3 cases); and dysplasia 5.8% (6 cases). There was no statistical significance in sex distribution of PCLs (P = 0.245). Conclusion: There is a low prevalence of H. pylori in this metropolitan population. Mandatory multiple topographically targeted biopsies, even with normal mucosal appearance, at gastroscopy in addition to surveillance of PCL are recommended for early detection of gastric cancer.
  1,157 204 -
Pulmonary extranodal marginal zone B-cell lymphoma of mucosa-associated lymph tissue: A case report and literature review
Y Wu, L Zhao, Y Chai
March 2018, 21(3):392-394
DOI:10.4103/njcp.njcp_393_16  PMID:29519992
Extranodal marginal zone B-cell lymphoma of mucosa-associated lymph tissue (MALT lymphoma) is a rare subtype of marginal zone B-cell lymphoma. Most primary MALT lymphoma occurs in the stomach, while lung is an uncommon site of MALT lymphoma. We herein report a case of MALT lymphoma in a 44-year-old female who underwent a pulmonary lobectomy and received rituximab plus CHOP chemotherapy regimen. The patient had an uneventful postoperative course and a good prognosis without tumor recurrence for 3 years.
  1,024 252 -
The effect of endodontic irrigants on the microtensile bond strength of different dentin adhesives
B Dikmen, B Tarim
March 2018, 21(3):280-286
DOI:10.4103/njcp.njcp_282_17  PMID:29519974
Objectives: The aim of this study was to determine the influence of irrigants on bond strength of adhesive systems. Materials and Methods: Superficial dentin surfaces of 60 extracted molars were divided into 15 groups, according to irrigants and adhesives. In the control groups, surfaces were irrigated with distilled water. In experimental groups, sodium hypochlorite (NaOCl), ethylenediaminetetraacetic acid (EDTA) + NaOCl, chlorhexidine (CHX), and NaOCl + sodium ascorbate were used as irrigants. Resin composites were then built up using Single Bond, Clearfil SE Bond, and Xeno 3 as adhesives. The microtensile bond strength of groups was determined. Data were statistically analyzed by two-way analysis of variance (ANOVA), one-way ANOVA, and the Bonferroni test. Results: NaOCl reduced bond strength of Single Bond and Clearfil SE Bond (P < 0.01). For all adhesive systems, EDTA + NaOCl-treated groups exhibited lower bond strength than control groups (P < 0.01). CHX decreased bond strength of Single Bond (P < 0.01). Application of sodium ascorbate improved compromised bond strength to NaOCl-treated dentin (P < 0.01). Conclusion: Different irrigants had several effects on bonding of different adhesives. Sodium ascorbate after NaOCl could restore compromised bond strengths.
  1,016 246 -
Dentists' Attitudes and perceptions toward protective mouthguards
S Raghavan, P Dayal, K Philip, MS Gahlot
March 2018, 21(3):318-326
DOI:10.4103/njcp.njcp_336_16  PMID:29519980
Objectives (Background): Risk of dental injury from contact sports can be prevented by the use of mouthguards. Dentists provide excellent information regarding mouthguards. Thus, the aim was to assess the awareness among dentists regarding the same, the level of training in fabricating a mouthguard and whether they regularly recommend one for their athletically active patients. Materials and Methods: This institutional cross-sectional survey was conducted in the Department of Orthodontics, Government Dental College, Kottayam, and Kerala, India. An online form was sent out to 1500 offices and departments in dental institutions through email with a time period of 1 month given to fill responses and was analyzed using descriptive statistics. Results: A response from 640 was recorded; most of them had not received or had fabricated a mouthguard during their dental training or private practice, even though one-third recommended one to their athletically active patients with a lack of formal training being the reason for not routinely advocating mouthguard usage. Most were aware of more than one type of mouthguards and recommended customized one for the same, however, more than half were not aware of a different type intended for orthodontic patients. Conclusion: It is not a routine practice currently, among general dentists and specialists alike, in our country, to prescribe a mouthguard. It is time that the dental fraternity spread awareness for the prevention of injuries. A relook into the academic curriculum while advocating the use of customized mouthguards to patients due to contact sports is required.
  1,001 221 -
Is there A Relationship between route of delivery, perinatal characteristics, and neonatal outcome in preterm birth?
ZN Dolgun, C Inan, AS Altintas, SB Okten, C Karadag, NC Sayin
March 2018, 21(3):312-317
DOI:10.4103/njcp.njcp_333_16  PMID:29519979
Background: Preterm birth is one of the most challenging problems in obstetric care and it is closely related to perinatal mortality and morbidity. The aim of the current study was to document our experience with preterm births and to analyze the association between perinatal variables and clinical outcomes. Methodology: In this retrospective study, data were derived from the medical records of 785 singleton preterm births delivered in the obstetrics and gynecology department of our institution. Variables under investigation were maternal and gestational ages, fetal gender, route of delivery (vaginal vs. cesarean section [C/S]), causes of preterm birth, birth weight, placental weight, umbilical cord length, and Apgar scores at the 1st and 5th min. Results: Pregnant women with advanced age (≥35 years) were more likely to undergo C/S (P < 0.001). Apgar score at the 1st and 5th min was influenced significantly by gestational age (P < 0.001), newborn birth weight (P < 0.001), placental weight (P < 0.001), and umbilical cord length (P < 0.001). Infants delivered due to antepartum fetal distress indication had remarkably lower Apgar scores at the 1st min and the birth weight seemed to be positively correlated with Apgar scores at both 1st (P < 0.001) and 5th min (P < 0.001). Apgar scores both at the 1st and 5th min were positively correlated with placental weight (R: 0.239 and 0.231, respectively, and P < 0.001 for both) and length of umbilical cord (R:0.228 and 0.211, respectively, and P < 0.001 for both). Conclusion: Advanced age pregnancies have higher C/S rates, but Apgar scores are significantly correlated with infant characteristics. Umbilical cord length and placental weight might be the new add-on predictors of postpartum well-being in premature infants.
  1,018 192 -
Is medial calcar continuity necessary in plate osteosynthesis for proximal humerus fractures?
CZ Esenyel, I Kalkar, M Adaş, SS Dedeoğlu, CD Büyükkurt, H Cabuk, AE Esenyel
March 2018, 21(3):362-366
DOI:10.4103/njcp.njcp_400_16  PMID:29519987
Objective: To evaluate the functional and radiological results of patients with and without medial calcar continuity in plate osteosynthesis applied for a proximal humerus fracture retrospectively. Methods: The study included 27 patients to whom plate osteosynthesis was applied because of a proximal humerus fracture between January 2, 2010, and December 30, 2013, at Okmeydanı Research and Training Hospital. Patients were separated into Group A with medial calcar continuity and Group B without medial calcar continuity. On the radiographs taken postoperatively and at the final follow-up examination, measurements were taken of the humeral head height and the humeral neck-shaft angle. The presence of avascular necrosis was recorded. Results: The functional and radiological results of the patients were evaluated after a mean follow-up of 39.1 months. No statistically significant difference was determined between Groups A and B in respect of the postoperative and the final follow-up humeral head height (P > 0.05). No statistically significant difference was determined between Groups A and B in respect of the postoperative and the final follow-up humeral neck-shaft angle (P > 0.05). Plate breakage was seen in one patient without medial calcar continuity. Penetration of the screw into the joint was determined in one patient in Group A and three patients in Group B. No avascular necrosis or infection was seen in any patient. Conclusion: When the surgical process has not damaged the soft tissue and sufficient stability has been achieved, providing calcar continuity is not an absolute condition.
  929 220 -
Dentists knowledge of lipid treatment of local anaesthetic systemic toxicity
G Oksuz, A Urfalioglu, T Sekmen, N Akkececi, N Alpay, B Bilal
March 2018, 21(3):327-331
DOI:10.4103/njcp.njcp_12_17  PMID:29519981
Context: Local anesthetics (LAs) are in widespread use by dental practitioners, and erroneous administration, such as intravenously or exceeding the maximum dose, can cause the life-threatening condition of local anesthetic systemic toxicity (LAST). Aims: The objective of the present study was evaluate the ability of dentists to recognize signs of LAST and quantify how often they have used lipids to treat LAST in dentistry patients. Materials and Methods: The study administered 600 questionnaires that asked about the frequency with which dentists encountered LAST and the symptoms of LAST and its treatment, especially with lipids. Results: The results showed that 520 (86.66%) respondents had never seen LAST, and 404 (67.3%) had no idea about lipid treatment. In addition, 128 (21.3%) had heard about lipid treatment but had inadequate knowledge of it and 59 (9.8%) had read an article about lipid treatment, but only 9 (1.5%) knew how to use lipid treatment. Finally, 80 (13.33%) participants had seen LAST but had used a treatment other than lipids. Conclusion: Dentists and all facilities using LA must be aware of LAST, and knowledge of lipid treatment must be increased by education. Twenty percent lipid solutions must be kept handy in their offices by dentists.
  919 213 -
Are roadside petrol dispensers at risk of oxidative stress? a study from gombe, North East Nigeria
S Adamu, OM Akinosun, FM Abbiyesuku, MA O Kuti, Jibril M El-Bashir, JD Abubakar
March 2018, 21(3):276-279
DOI:10.4103/njcp.njcp_186_17  PMID:29519973
Background: Gasoline is one of the most frequently utilized chemicals whose use is on the increase. Exposure to the volatile constituents of gasoline generates free radicals leading to oxidative stress. This is associated with nucleic acid, lipids, and protein damages leading to chronic diseases including cancers. Occupational exposure to this product is of public health concern, especially in the developing countries where the awareness and enforcement of safety measures are not adequate. Materials and Methods: Plasma level of total antioxidant status (TAS) was compared between 90 roadside dispensers of gasoline and 90 age- and sex-matched controls. TAS was measured using standard colorimetric method. Results: The mean age of the exposed and control groups is 29.03 ± 3.7 and 29.24 ± 3.5 years, respectively. The mean plasma TAS level of the exposed (0.60 ± 0.33 mmol/L) was significantly (P < 0.001) lower than that of the controls (1.29 ± 0.25 mmol/L). Conclusion: Our data have demonstrated higher level of oxidative stress in roadside dispensers of gasoline compared to the controls. This is an indication that roadside gasoline dispensers are probably at greater risk of developing chronic diseases associated with increased oxidative stress. Antioxidant supplementation may be of benefit to the roadside gasoline dispensers. Legislation on roadside gasoline dispensing should be enforced to reduce the incidence of long-term complications from repeated exposures.
  995 129 -
Volar percutaneous screw fixation for scaphoid nonunion
M Gurger, M Yilmaz, E Yilmaz, S Altun
March 2018, 21(3):388-391
DOI:10.4103/njcp.njcp_24_17  PMID:29519991
Background: Percutaneous screw fixation is widely used in acute fractures of the scaphoid. In this study, we aimed to present our results with volar percutaneous screw fixation in patients with scaphoid nonunions. Methodology: A total of 12 patients with scaphoid nonunion (≥13 weeks) that underwent volar percutaneous screw fixation were evaluated retrospectively. Two of the patients were female, and 10 were male. Mean age was 27 years (range = 19–41). The mean time that elapsed between the fracture and surgical procedure was 7.5 months (range = 4–12). According to the anatomic location, 33.3% were proximal pole, and 67.7% were waist fractures. All of the patients underwent percutaneous fixation with a headless cannulated screw from volar part under fluoroscopic guidance. Clinical evaluation was performed according to the modified mayo wrist scoring system (MMWS). The absence of a radiolucent fracture line on the radiographs was considered “union” on radiological evaluation. Results: The mean follow-up time was 18 weeks (range = 8–36). Union was achieved in all patients (91.6%), except one. The mean time to union was 15.5 weeks (range = 8–30). Based on MMWS system, 8 patients were interpreted as excellent, 3 patients as good. Conclusion: Percutaneous fixation in appropriate patients provides satisfactory results with high union and minimal complication rates in scaphoid nonunions.
  938 186 -
Nonspecific abdominal pain: A follow-up survey
N Koyuncu, O Karcioglu, S Sener
March 2018, 21(3):332-336
DOI:10.4103/njcp.njcp_30_17  PMID:29519982
Introduction: Little data have been published on the outcome of patients discharged from the emergency department (ED) after being diagnosed with nonspecific abdominal pain (NSAP). This study aimed to investigate short-term follow-up of patients discharged with a diagnosis of NSAP from the ED. Materials and Methods: This prospective, observational study was conducted in the University-based ED and enrolled all consecutive adult patients who were diagnosed as NSAP out of patients presented with abdominal pain (AP). The main outcome measure was the presence of recurrent AP resulting in referral to the ED and specific diagnoses within the first 3- and 90-day postdischarge. On the 3rd and 90th days, all patients discharged with NSAP from the ED were asked questions, and their response entered into a questionnaire. Results: A total of 684 patients presented with AP, of which 299 (46%) had a diagnosis of NSAP within the 4-month period. Fifty cases (16%) could not be included due to inability to access. Eighty-one out of 249 patients (32.5%) complained of recurrent AP within the first 3 days. Twenty-two cases (8.8%) were readmitted to ED once again in the meantime, and ten received specific diagnoses including three with acute abdomen. Within 90 days, additional nine patients out of 20 (45%) with recurrent AP received specific diagnoses including two with acute abdomen. Conclusions: Certain specific underlying entities can be missed in patients considered to have NSAP and discharged from the ED. Adherence to timely follow-up and repeated examinations are of vital importance in these patients.
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A study on shotgun injuries to the craniomaxillofacial Region in a Nigerian Tertiary Health Center
EB Edetanlen, BD Saheeb
March 2018, 21(3):356-361
DOI:10.4103/njcp.njcp_315_17  PMID:29519986
Context: Short-range shotgun wounds of the craniomaxillofacial region are life-threatening and are as devastating as military rifle wounds. Aims: This study aimed to evaluate the pattern of presentation of craniomaxillofacial shotgun injuries, types of shotgun injuries, and the outcome of treatments in our environment. Setting and Design: This is a prospective observational study. Materials and Methods: This is a prospective observational study conducted from February 2006 to March 2012. All patients with shotgun wounds to the craniomaxillofacial region were included in the study by convenient sampling method. Glezer's shotgun classification scheme was used to categorize the patients into short-, intermediate-, and long-range shotgun wounds. Data collected were analyzed using SPSS version 16. Statistical Analysis Used: Descriptive statistics were used to calculate the data. Mean and standard deviation (SD) were calculated for all quantitative variables such as age. Frequency and percentages were presented for qualitative variables. Results: A total number of 28 patients were seen. Ages ranged from 19 to 64 years with a mean (±SD) of 32.7 (±11.4) years. The two most commonly used shotguns were locally made pistol (25, 42.9%) and the cut-size gun (10, 35.7%) and the least commonly used was Dane gun (1, 3.6%). Close-range injury to the face was 17 (60.7%) while that of intermediate- and long-range injuries were 6 (21.1%) and 5 (17.9%), respectively. Conclusion: Wounds sustained from close-range shotguns to the face were the most common in this environment. The outcome of treatment was satisfactory when treated with conservative debridement and early reconstruction.
  957 123 -
Idiopathic multiple eruptive milia: Report of a case in a nigerian woman
H Yahya
March 2018, 21(3):395-396
DOI:10.4103/njcp.njcp_43_17  PMID:29519993
Milia are multiple, small, benign keratin-filled superficial epidermoid cysts which are classified as primary when they occur spontaneously or secondary when they result from skin trauma or disease. Multiple eruptive milia (MEM) refer to a condition characterized by a sudden eruption of a large number of milia. MEM may be familial, occur as part of a genodermatosis, or occur spontaneously when they are termed idiopathic. Idiopathic MEM are an exceedingly rare disease. We present the case of a 70-year-old Nigerian woman with idiopathic MEM.
  886 90 -
Turkish health field periodical editors' Views on publication process and ethical problems
H Pars, R Akın, NE Sahin, S Cinar, F Aslan, S Duygulu
March 2018, 21(3):264-270
DOI:10.4103/njcp.njcp_49_17  PMID:29519971
Objective: We aimed in this study to investigate views and suggestions of health field editors about the publication process and ethical problems. Materials and Methods: The study involved 42 journal editors who accepted to participate in the study. The data were collected through 70-item “Editor Views Questionnaire” which was developed by the researchers in line with the related literature. Results: The editors who participated in the study were asked about their views about the most common problems they encountered related to publication ethics; the top three problems indicated by the editors included unjustified authorship (40.5%), duplicate publication (33.3%), and falsification (26.2%). An analysis of the problems encountered in the initial evaluation stage revealed the top three issues as articles that did not follow the writing rules of the journal (33.3%), unqualified articles (30.1%), and negligence of the author(s) (14.3%). Views in relation to the problems about the referee evaluation stage included evaluations that were not completed within the time given (28.6%), insufficient importance attached to the evaluation (23.9%), and inability to find sufficient number of referees (16.7%). Conclusion: some editors were found to encounter violation of publication ethics, to experience problems in the revision stage, and not to feel fully independent in their contribution to article publication and thus the improvement of the journal quality. Identification of journal editors' views and problems is an important step for the solution to these problems; it could thus contribute to improving the quality of publication process and journal quality.
  805 163 -
Effects of Postsurface Treatments Including Femtosecond Laser and Aluminum-oxide Airborne-particle Abrasion on the Bond Strength of the Fiber Posts
AR Tuncdemir, EB Buyukerkmen, H Celebi, A Terlemez, Y Sener
March 2018, 21(3):350-355
DOI:10.4103/njcp.njcp_425_16  PMID:29519985
Context: Bond strength of fiber posts. Aims: The purpose of this study was to evaluate the effect of different Post Surface treatment techniques on the push-out bond strength of the quartz fiber posts. Subjects and Methods: A total of 30 maxillary central incisors were decoronated at cementoenamel junction. Root canals were filled and postspaces were prepared. The specimens were classified into three groups according to the surface treatment performed to the postsurface (n = 10) as no surface treatment (control group) (Group 1), A 50-μm aluminum-oxide airborne-particle abrasion group (Group 2), femtosecond laser (FS) group (Group 3). A self-curing adhesive cement was used for cementation of posts. Six sections (two coronal, two middle, and two apical) of 1-mm thickness specimens were prepared with a slow speed diamond saw. Specimens were stored in distilled water at 37°C for 24 h. Then, push-out test was performed on a universal testing machine. Results: The data were analyzed by one-way ANOVA (α = 0.05). The test results indicated that push-out test values significantly different according to surface treatments among groups (P < 0.05). There were no significant differences between root sections of each group for bond strength (P > 0.05). All dislodged Group 3 posts were free of cement, indicating adhesive failure, Group 1 and 2 were partially coated with cement, indicating a mixed failure at the cement/postsurface. Conclusions: Based on the results, aluminum-oxide airborne-particle abrasion group showed higher and FS irradiation group showed lower bond strength values. Push-out bond strength values of the root segments were the same in all groups.
  755 135 -
Laparoscopy in the management of lumboperitoneal shunt catheter in obese patients with pseudotumor cerebri
S Ozturk, H Cakin, K Karabulut, R Pasahan, M Kaplan
March 2018, 21(3):397-400
DOI:10.4103/njcp.njcp_50_17  PMID:29519994
Lumboperitoneal shunts are widely used for the treatment of patients diagnosed with pseudotumor cerebri (PTC). Obesity is a risk factor for PTC. In particular, catheter migration out of the abdominal cavity is more commonly observed in morbidly obese patients. The aim of this study was to discuss the underlying mechanisms of catheter migration and treatment modalities in morbidly obese patients with PTC. The present study included four morbidly obese patients. All cases had undergone the previous laparotomy for insertion of a distal catheter into the abdominal cavity. In three cases, migration of the distal catheter out of the abdominal cavity was observed. Migration of the proximal tip of the catheter out of the spinal canal was observed in the fourth case. In all cases, laparoscopic revision surgeries were performed. During revision surgery, a catheter tunnel was prepared immediately over the external oblique fascia to obtain the shortest and deepest tunnel, and a distal catheter was inserted by laparoscopic guidance posterolaterally, i.e., through the postaxillary line. None of the patients developed any complications during the follow-up period of 4 years. We recommend laparoscopic insertion of distal catheters through the postaxillary line into the abdominal cavity using as short a catheter route as possible. Thus, tension and traction on the catheter due to abdominal movements can be decreased in morbidly obese patients to prevent catheter migration.
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